Strategies to Achieve Alignment, Collaboration, and Synergy across Delivery and Financing Systems

Strengthening the Carrying Capacity of Local Health and Social Service Agencies to Absorb

Increased Hospital/Clinical Referrals

Research In Progress WebinarWednesday, February 7, 2018

12:00-1:00 pm ET/ 9:00 am-10:00 am PT

Funded by the Robert Wood Johnson Foundation

AgendaWelcome: AnnaG.Hoover,PhD

Co-Director,RWJFSystemsforAction NationalCoordinatingCenterUniversityofKentuckyCollegeofPublicHealth

Presenters: DanielleVarda,PhD KatieEdwards,MPAAssociateProfessor,SchoolofPublicAffairs ExecutiveDirectorDirector,CenteronNetworkScience TheNonprofitCentersNetworkUniversityofColoradoDenverDanielle.Varda@ucdenver.edu katie@nonprofitcenters.org

Commentary: KameronHodgens,PhD KinseyAdamsonCEO/ExecutiveDirector OperationsAssistantTheGlasserSchoenbaumHumanServicesCenter ServeDenton

QuestionsandDiscussion:ModeratedbyDr.Hoover.

Presenter

Dr.DanielleVarda isDirectoroftheCenteronNetworkScienceandanAssociateProfessorintheSchoolofPublicAffairs.ShewaspreviouslyattheRANDCorporation,wheresheworkedasanAssociatePolicyScientistfrom2005-2008.Shespecializesincollaborativegovernanceandnetworkleadership,focusingspecificallyinPublicHealthSystemsandServicesResearch.Herresearchfocusisonevaluatingthenetworkstructureofinterorganizational collaborationsbetweenthepublic,private,andnonprofitsectorsandthesubsequentnetworkeffectsoftheserecordedinteractions.SheistheauthorofthePARTNERToolandthePerson-CenteredNetworkApp.ShehasbeenPIonover25projects,withfundingrangingfromfoundationtofederaltolocalinitiatives.Dr.Vardawillberesponsibleforleadingthework,managingtheteam,datacollection,analysis,anddissemination.

Presenter

Ms.KatieEdwards istheExecutiveDirectorofTheNonprofitCentersNetwork,anationalnetworkof170nonprofitsharedspacecentersthatencompassover3,300nonprofitswholocatetogetherforimprovedimpactandgreatercollaborationandreducedoperatingcosts.PriortojoiningNCN,shereceivedherMastersofPublicAdministrationwithanemphasisinNonprofitManagementfromIndianaUniversity.Shehasresearchedandparticipatedinthesharedspacesectorforsevenyears,authoringseveralpractitioner-focusedpublications.Edwardswillberesponsibleformanagingcommunityrelationshipsandconfiguringproductsthatwillfocusontranslatingtheresearchforusebythesharedspacenonprofitcommunity.

Commentary Speaker

Dr.KameronPartridgeHodgens,aSarasotanative,graduatedfromFloridaStateUniversitywithaB.S.inPsychologyandinSpecialEducationandreceivedbothherM.A.andherPh.D.inLifespanDevelopmentalPsychologyfromtheUniversityofAlabamaatBirmingham.ShecompletedherpsychologytrainingattheCivitan-SparksClinicsinBirmingham,specializingindevelopmentaldisabilitiesandsiblingrelationships.

UponmovingbacktoSarasotain2007,Dr.Hodgens becametheVicePresidentofProgramsandServicesatEasterSealsSouthwestFlorida.InOctoberof2014,shejoinedtheGlasserSchoenbaumHumanServicesCenterastheCEO,apositionthatsheishonoredtohave,giventhetremendousimpactofthecenterandtheesteemedlegacyoffounderDr.KayGlasser.

Dr.Hodgens isagraduateoftheLeadershipSarasota2010-2011class,servesastheViceChairoftheLeadershipCouncilfortheGreaterSarasotaChamberofCommerce,isamemberofDesigningDaughtersandofSarasotaCounty’sCommunityAlliance,servedontheManateeCountyChildren’sServicesAdvisoryBoardfor5years,wasrecognizedasthePublicCitizenoftheYearin2014bytheNationalAssociationofSocialWorkers- Sarasota/ManateeUnit,andisa2015winnerofSRQMagazine’sWomeninBusinessAward.SheisalsoamemberofWomenUnited,anaction-orientedandphilanthropicprogramofUnitedWaySuncoast.

KameronlivesinSarasotawithherhusbandBart,her2-yearolddaughterEvelyn(“Evy”),andasassy17-yearoldblackcatnamedMinuit(“Min-wee”).

Commentary Speaker

Ms.AdamsonworksastheOperationsAssistantforServeDenton.Sheprovidesoveralladministrativesupportfortheorganization,actsasthestaffliaisonforeachnonprofitagencypartneringwithServeDenton,andcontributestothegeneraldevelopmentofmajordonors.KinseygrewupinDenton,Texas.AftergraduatingwithadegreeinRecreation,ParkandTourismSciencesfromTexasA&MUniversity,shespenttwoyearsworkingastheConferenceandEventsInternforCru.KinseyishappytobebackinherhometownandisexcitedaboutworkingtofurthersupportandenrichtheDentoncommunity.

Strengthening the Carrying Capacity of Local Health and Social Service Agencies to Absorb Increased Hospital/Clinical ReferralsPROJECT DATES: NOVEMBER 2017 TO SEPTEMBER 2019

Our Team, and How We Came Together

University of Colorado Denveru Danielle Varda u Todd Elyu Becky Hofkesu Malinda Mochizuki

University of Kentuckyu Rachel Graham

The Nonprofit Centers Networku Katie Edwards

Serve Dentonu Pat Smithu Carlie Kubanu Kinsey Adamson

The Glasser Schoenbaum Human Services Centeru Kameron Hodgensu Charlene Altenhain

Trailhead Instituteu Sarah Lampe

Project Overview

The project is focused on the system alignment between the medical and public health referrals to community resources as the result of increased screening on social determinants of health.

Goals of the project are to answer:1) What kinds of resources and services does the nonprofit sector provide to

changing health systems?2) What is the impact on the carrying capacity of the nonprofit sector as health

systems’ dependence on the sector increases?

Aims

u Aim 1 – Define “community resources” in a SDOH screening and referral systems context.

u Aim 2 – Determine which factors make up the “system” that determines the nonprofit carrying capacity of a community.

u Aim 3 – Identify the existing and potentially innovative financing mechanisms involved in integrating the delivery of hospital/clinical and public health services in a way that is equitable for all populations.

u Aim 4 – Develop strategies to prepare and build the carrying capacity of the nonprofit sector to respond to the growing demand.

Team Roles and Responsibilities: A Community Based Participatory Research Approach

Community Partners

Community/ Research

PartnershipResearch Partners

• Context/Content Expertise• Community Connections• Info on Data Access and

Availability

• Data Collection• Data Analysis• Analytic Model

Development

• Interpretation of Findings• Translation of Findings to

Practice• Dissemination to different

audiences

THE PROBLEM WE ARE WORKING TO SOLVE

60%

40%

90%

20%

70%

CommunityCarryingCapacityCurrentSystem

What factors are part of the “system” that determines the nonprofit carrying capacity of a community?

100%

90%

80%

90%

90%

CanThisModelInformCapacityBuilding:

§ HospitalCommunityBenefitDollars

§ Local,State,FederalorFoundationFunding

§ ReimbursementsforSocialServiceDelivery

How are these factors impacted when a system’s SDOH screening and referral begin to increase the demand for these services in an already stressed sector?

100%

90%

80%

90%

90%

What additional complexities and factors are not as clear now, but must be considered to develop a functioning system?

Project Sites& Focus Areas

u Glasser Schoenbaum Human Services Center (Sarasota, FL)

u Serve Denton (Denton, TX)

Community Identified Project Focus Areas:Ø Opioid Ø Housing

Methods

Tasks and TimelineDates Task Items to be CompletedFall 2017 Task 1 § Analysis of existing dataset – looking at the role of nonprofits in cross-sector

interorganizational networks

Spring 2018 Task 2 § Literature review to identify measures of carrying capacity§ Develop a preliminary/draft framework to measure carrying capacity§ Interview guide for key informant interviews; Scheduling interviews

Summer 2018 Task 2 § Key informant interviews – Denton, TX and Sarasota, FL

Summer 2018 Task 2 § Interview analysis§ Finalizing framework based on interviews

Fall 2018 Task 3 § Data Collection/Gathering: Finance data, organizational data, PARTNER survey

Spring 2019 Task 3 § Analysis of the PARTNER survey (Network capacity)§ Analysis of available financial and program data (Financial capacity)§ Testing of this project’s carrying capacity measures framework

Summer 2019 Task 4Task 5

§ Systems mapping – how do these measures relate to feedback loops?§ Dissemination (report, highlights brief, presentations)

Task 1 SECONDARY DATA ANALYSISSYSTEMATIC LITERATURE REVIEW

Research Design - Secondary Data Analysis

u Project Goals: To build an evidence-based to model how increased demand on the sector may impact community carrying capacity

PARTNERProgram to Analyze, Record, and Track

Networks to Enhance Relationships www.partnertool.net

Description of the Data

u Secondary Data Analysis of PARTNER datau 2000+ Whole Networks

u 60,000 Organizationsu 200,000 cross sector partnerships (dyads)

u Sample: Pulled data available from existing community level networks of cross-sector, interorganizational networks from across the US- Health Focused Networks; Each One Includes Hospitals; Not

All Involve Public Health

u 111 Whole Networksu 2,980 organizations

u 48,745 cross sector health related partnerships (dyads)

Research Question 1

u # of Organizations from 10 sectorsN=2,980; NPOs = 2,618

• What are “community resources” in a SDOH context?

• What is the size and scope of the nonprofit organizations identified as potential resources?

Next Step: Breaking Out Sectors in More Detail

u Organizations Coded by IRS Nonprofit Categories (501(c))

What did we learn?

• Public Health is the most connected, NPO vary by type, and health systems are less connected

• Trust and Value = higher for PH and Health than Nonprofits

What did we learn?

• Public and nonprofit agencies contribute more than private agencies

• Orgs that contribute the most resources (public and nonprofit agencies) are not regarded as valued as private sector agencies

• Negative relationships between # of connections and resource contribution (e.g. nonprofit contribute more but are less connected)

RelationshipBetweenOrgSectorTypeandResourceContribution

Task 2 DEVELOPMENT OF CONCEPTUAL FRAMEWORK

Building the Conceptual Framework

u Review of the literature – in progressu Definition of ‘community’u Definition ‘community

carrying capacity’ u Review of available

outcomes, indicators, and measures of carrying capacity

u Determine which are relevant for this project

u Ideal vs feasible/realisticu Team consensus – via

voting?u Draft community carrying

capacity data infrastructure

Next Steps

u Complete the Conceptual Modelu Define Operational Measures

u Task 3: Conduct Interviews to:u Get Feedback u Validate Assumptions

u Test Feasibility of Collecting Datau Finalize Model

u Task 4: Collect all the data we can to feed and test the modelu Task 5: Develop systems map and disseminate

Community Partners

& Commentary

Glasser Schoenbaum Human Services Center (Sarasota, FL)

Serve Denton (Denton, TX)

Mission Statement: To be the leader in providing a collaborative community of high quality, accessible facilities for the local human services nonprofit sector.Current Tenant Partner Agencies:

u AARP Foundation WorkSearch

u Bay Area Youth Services, Inc. (BAYS)

u Children’s Guardian Fund

u Coastal Behavioral Healthcare

u Early Learning Coalition of Sarasota County

u Epilepsy Services of Southwest Florida

u First Step of Sarasota

u Healthy Start Coalition of Sarasota County

u Insight Counseling Services

u Jewish Family and Children’s Services

u Literacy Council of Sarasota, Inc.

u More Too Life

u Babies & Children’s Medical Center, Sarasota County Health Dept.

u The Salvation Army, Quality Life Center

u Sarasota County Openly Plans for Excellence (“SCOPE” – as of 3/01/18)

u Suncoast Partnership to End Homelessness

u UnidosNow

1750 17th StreetSarasota, FL 34234(941) 365-4545www.gs-humanservices.org

2016 Campus Facts, Figures, & Impact u 17 Agencies - 14 buildings - 5 acres – 1 campus

u Tri-county reach: Sarasota, Manatee, & DeSotou Home to 56 agencies during our 28 years

u 48,000 square feet of office spaceu Served over 45,500 individuals

u $8.50/square foot/year

u All overhead & maintenance expenses included (except phone & Internet)u $15 million in overhead saved since 1990

u $16.9 million dollars in 92 programsu 117 full time staff, 32 part time

u 770 volunteers

u Approximately $500,000 saved annually

MissionServeDentonisa501(c)(3)community-basedorganizationthatsupports

nonprofitsthatopendoorsforpeopletobecomeself-sufficient.

LocationsServeDentonownsandoperatestwoproperties:TheWheelerHouseandtheServeDentonCenter.

TheWheelerHouse

TheWheelerHouseisatransitionalhousingfacilityformomsandtheirkidsmanagedbyGivingHope,Inc.andanaffordablehealthclinicmanagedbyHealthServicesofNorthTexas.OpeningJuly2015,TheWheelerHousehasserved79momsandtheirkidsaswellasover1,600patients.

ServeDentonCenter

TheServeDentonCenterisa32,500squarefootbuildingthatcanaccommodate

multiplenonprofitserviceproviders inoneconvenientlocationforanaffordableprice

sothoseinneedonlyhavetovisitonelocationtoreceivehelp.

WhoisServeDenton?

Vision• ServeDentonstrivestobea one-stop-shopforsocialservices.• Fillall19rungsonourSelfSufficiencyLadderbyhavinganonprofitaddresseachissue.• Improvecollaborationamongstnonprofitsbyofficinginonelocation.• Createopportunitiesforpeopletobecomeself-sufficientbyprovidingaccessible

servicesinonelocation.

OurCommunity

*UnitedWayInc.2017CommunityNeedsAssessment

ReasonsforExperiencingHomelessness

MostPressingNeedforHomeless

Questions/Comments

Upcoming Webinars

Archives http://systemsforaction.org/research-progress-webinars

UpcomingWednesday, February 21, 2018 12-1pm ET/ 9-10am PTLINKING MEDICAL HOMES TO SOCIAL SERVICE SYSTEMS FOR MEDICAID POPULATIONSNational Committee for Quality AssurancePrincipal Investigators: Sarah Scholle, DrPH, and Keri Christensen, MS

Wednesday, April 11, 2018 12-1pm ET/ 9-10am PTTESTING AN INTEGRATED DELIVERY AND FINANCING SYSTEM FOR OLDER ADULTS WITH HEALTH AND SOCIAL NEEDSNew York Academy of Medicine, New York University Principal Investigators: Jose Pagan, PhD, and Elisa Fisher, MPH, MSW

Wednesday, April 25, 2018 12-1pm ET/ 9-10am PTTESTING A SHARED DECISION-MAKING MODEL FOR HEALTH AND SOCIAL SERVICE DELIVERY IN EAST HARLEMNew York City Department of Health and Mental HygienePrincipal Investigators: Carl Letamendi, PhD, MBA, and Jennifer Pierre

Acknowledgements

Systems for Action is a National Program Office of the Robert WoodJohnson Foundation and a collaborative effort of the Center for Public HealthSystems and Services Research in the College of Public Health, and theCenter for Poverty Research in the Gatton College of Business and Economics,administered by the University of Kentucky, Lexington, Ky.

and

Questions?

www.systemsforaction.org

Topic SummaryAshospitalsandclinicsincreasescreeningsforsocialdeterminantsofhealth(SDOH),referralstoagenciesthatprovideservicestoaddresstheseneedsalsowillincrease.However,questionsremainabouttheabilityofnonprofitsandother“communityresources”toabsorbtheseincreasedreferralsforservices.

Usingsecondarydataanalysis,areviewofexistingcapacityassessmentmodels,andcasestudiesofhumanservicecentersinFloridaandTexas,researcherswilldevelopandimplementanapproachforassessingthecapacityofcommunitysocialservicesorganizationsandtheirpartnerstoabsorbandmeettheneedsofreferredclients.

Findingswillleadtoimprovementsinunderstandingthenonprofitandpublicsector’sabilitytorespondtogrowingdemand,ultimatelycontributingtothelong-termgoalofstrengtheningcross-sectorpartnershipsandintegrationofservicesandsystemstoimprovehealthoutcomes.